The Qualitative And Quantitative Research On The Present Situation Of Medical Students' Professionalism Dilemmas

Objective: By understanding the professionalism dilemma that medical students participate in or witness during internship,discussing the influencing factors of medical students' professionalism dilemmas,providing suggestions for medical students to solve the professionalism dilemmas,strengthening the cultivation of medical students 'professionalism and promoting the healthy development of medical students' professionalism.Methods: 1.Focus group interview: 51 medical students in the seven-year professional fifth-year medical students were selected as the interviewees,and 5 groups of focus groups were interviewed.After the interview,the interview data was imported into the qualitative analysis software Nvivo11 for analysis.2.Questionnaire survey: A cluster sampling method was used to select 262 medical students from the fifth grade of seven-year majors of China Medical University to issue 262 questionnaires and 260 valid questionnaires.The questionnaire used was self-designed based on qualitative data analysis results.SPSS 20.0 software was used for statistical analysis,using single-factor Logistic regression analysis and multivariate logistic regression analysis Results:1.Qualitative analysis: Using the grounded theory to analyze the theoretical framework for constructing professionalism dilemmas:(1)Tight relationship between medical students and patients in clinical practice;(2)Unfair treatment of medical students in clinical practice;(3)The responsibility exceeds the ability of medical students in clinical practice;(4)the conflict between medical education and patient care;(5)the conflict between scientific research and clinical practice.2.Quantitative analysis:(1)According to the questionnaire survey,the probability of professionalism dilemmas for medical students was 87.3%.Qualitative analysis shows that in the 12 professionalism dilemmas,there are 9 scenes where the probability of professionalism dilemmas is more than one-third,and the probability that these 9 professionalism dilemmas are distressed is more than 85%;(2)The results of univariate logistic regression showed that whether the medical institutions provided protection had a significant influence on the probability of occurrence of professionalism dilemmas scenarios in different occupations(P<0.05).Whether or not the medical institution provides protection has a significant effect on the probability of trouble in different professionalism dilemmas scenarios(P<0.05).The results of multivariate logistic regression analysis showed that gender,department,and professionalism have significant influence on the probability of professionalism dilemmas scenarios.Female medical students in the department of surgery(OR=2.09,P<0.05)are more likely to face the professionalism dilemma in which the patient does not respect and does not understand that medical students cannot communicate successfully.Women who believe that professionalism is very important(OR=2.57,P<0.01)are more likely to face the professionalism dilemma that cannot fully follow the standard in clinical practice.Medical students who do not provide protection and have a good understanding of professional mentality(OR = 9,09,P< 0.01)are more likely to experience confusion in their professionalism dilemmas because they are not able to implement clinical norms in accordance with standards in their daily clinical practice.Conclusion: It is found that in the clinical practice of medical students occur the most common type of medical students suffering great difficulties in the professionalism dilemma;affect the medical students professionalism dilemma occurs in the factors of gender,departments and the importance of professionalism;impact of medical students Factors that plagued the professionalism dilemma include the protection mechanism provided by medical institutions and the understanding of professionalism;and suggestions for reducing the professionalism dilemma of medical students.